My mom has taken a pretty steep decline in the last couple months. She is extremely frail. Been diagnosed with diastolic heart failure, chronic respiratory failure with hypoxemia on oxygen most of time now, reactive airway disease and atrial fibrillation for 20 years on Coumadin. She fell out of bed this morning and broke her hip., a hip she had replaced 8 years ago. They’ve decided to do surgery after her INR normalizes. I’m preparing myself for what’s to come. From what I’ve observed with others especially when frail this really changes things. Any thoughts on what i can likely expect? Thanks.
today she has become much more confused and delusional. Diagnosed yesterday with a UTI and urinary retention so had to go back on Foley catheter. Today had fluid on lungs and put on Lasix. Most of day today has been yelling help because of the pain and during PT. They say they don’t want her sedated but I see that being the only way she’s not totally miserable. So they just give her Tylenol but finally gave her some oxycodone which did finally help.
it’s so sad to see it. She can’t move without being in tremendous amount of pain on that side. She absolutely cannot put weight on the side of her surgery, not for 6 weeks. The day after the surgery she tried to put weight on it during PT because I don’t believe she has the reasoning power left to not put weight on it. They’ve had to stop PT more than once. Test was able to sit in a chair for a bit. But basically she’s languishing in bed until they try again.
my brother came in today and immediately got to work trying to feed her and encourage her to eat. She did eat some. I’m sure he felt better. Not sure about her. After he left she went into full delirium yelling for help, in obvious pain, agitated, pulling out her oxygen line and not knowing where she was. Reaching for things that weren’t there. It was horrible.
i understand that in hospital they’re first priority is to get her back to her baseline, which wasn’t good and why she fell out of bed to begin with. Right now I just want her to be comfortable and out of pain, whatever it takes. Other family members seem in denial and want to keep treating her many issues and I just can’t keep watching. They’re fighting to keep her alive and I’m fighting to let her go in peace. Simply heartbreaking….
I went in to see her in postop. She’s been through many surgeries but I’ve never seen her like that. Her face didn’t even look the same. She looked totally lost. She didn’t even recognize me or my brother. I was reading about post surgery delirium in the elderly as a real thing with various outcomes. So I guess time will tell. When I try to peer into the future in my head all I see is one big question mark. Obviously we couldn’t have avoided this as she was in incredible pain with the broken hip replacement.
Thank you so much for your update to us.
We just dealt with very unrealistic mother in law who had fallen and broken her pelvis . No surgery , but she had 4 comorbidities . She became unresponsive in rehab . Then with speaking with the doctor , My husband filled out and signed a Molst form , just to give basically hospice care . She died 3 days later. A bad fall can be the beginning of the end . She had been declining more rapidly before the fall . I believe had she not fallen she only had a few more months left anyway .
my mothers situation was very similar to yours. She was already very much on the decline and I also believed she had only a few more months. Then this happened. The dr said she would be going to rehab. But everything at this point is very uncertain because we don’t know what she’s left with as far as ability to recover.
Hope this doesn’t offend but I believe she and you were better off the way it played out in the end for your mother, you and your family. No more suffering for all involved. Best wishes to you as you move forward.
Om my lands! Her bones are breaking and they want CPR performed in the event she codes on the table! Is he insane?!?!
How you step back; dear brother, you are in denial or wanting to torture our poor mom, I absolutely refuse to be a participant in this insanity any further. I love mom and dread losing her but, I will not be a participant in this insanity of torture and denial. Good bye - Good luck! Yes, I intended to be redundant.
I pray that your mom doesn't suffer because she has made this choice and shared it with your brother.
My dad was a big, robust guy and CPR damaged his ribs, CPR will cave your mother's ribs in, why would he want that for her? Seriously ask him this after you show how violent real CPS actually is.
Great big warm hug! I can't imagine your distress over this.
Even though I kind of knew, it was incredible the reality of what it really means. TV has truly given ppl a sense of false hope. Not saying that it can’t be useful under the rt setting. But the actual percentage of ppl that survive is MUCH lower than the public is lead to believe. And also the effects it has on emergency personnel and healthcare providers in an elderly person that could have died with dignity instead of a violent attempt to save their life and for what.
We love the thought of someone swooping in and saving our life and living happily ever after. But TV and reality are most of the time quite different.
in preop the drs asked my mother if there was anything wrong with her heart or lungs and she basically said no. I was, again in disbelief. But I do believe she thinks she will get back to her independent status or at least where we can be at her beck and call in her own home. Then I spoke up and told him the actual diagnoses made by a pulmonologist less than a week ago. The anesthesiologist did not want to intubate her because of potential complications and explained she would be breathing on her own. After we talked to the surgeon they came back and said yes she would be intubated after all. I believe the surgeon has some definite ideas of the issues that will affect her in surgery and out. He was pretty straightforward.
so here we are and no one but me wants to discuss what might be the game plan going forward. My brother says to the surgical care team, as she turns 90 in a couple weeks, that we’re trying for 100 yo. I just can’t even fathom…. I truly believe they think she’s going to bounce back as she always has. But back to what?? Because of family dysfunction I believe there are some deep psychological issues in someone who wants to keep a frail 90 yo woman alive at all costs. He wants total control of her care and I’m about ready to give it to him.
I would be asking every person involved if this was them or their mom what would they do. I have found that you get a better perspective on the situation when you put the shoes on their feet.
I pray that she doesn't suffer, whatever happens.
You be sure and take care of you, this could be a long haul or a short one and you need to be rested for whatever it is.
Just curious, where is the bro and SIL that think this is such a good plan? Resting comfortably in their own bed? They should be pulling the all nighters, since this is their decision.
May The Lord give you strength, rest and peace during this difficult time.
I know years ago she was diagnosed with osteopenia. So yes I believe her bones are brittle.
I am surprised but then again not really that the doctors have not mentioned Hospice.
Seems to me that if a doctor mentions the word Hospice they are denying their training.
Doctors are taught to CURE. And sometimes that means to cure at all costs.
I think there should be a full rotation in med school on Hospice. Not a few hours but enough so that they TRULY see the benefits of Hospice.
I wonder if your your brother and SIL would accept Hospice as the best option if the doctor recommended it.
Sorry you have to watch your mom go through this.
And I wonder what she would say if she were cognizant. (another point to ponder)
I just can’t imagine what she is going to go through after this surgery, if she makes it through at all. They say she will have a huge scar because of what they have to do to stabilize and repair the bone along with replacing the old hip replacement prosthesis. It sounds simply horrific to me and I have some medical knowledge and can’t imagine postop is going to be any better. My brother and SIL act like it’s like her other surgeries and hospitalizations. Mind you, this is her 7th hospitalization in 2 years. Still no mention of hospice by them with what’s happened and I know if I bring it up AGAIN it probably won’t go well.
She’s so incredibly frail I just can’t believe we’re here. She’s bed bound with a catheter, in and out of confusion and it’s hard for me to see she’s going to be better off with surgery but it really does seem out of my hands. The good thing is I think the morphine and muscle relaxers have finally controlled her pain.
I’m thankful for this forum and all the comments.
Also, I'm shocked she's still on Coumadin and hasn't been put on Xarelto or one of the other less aggravating blood thinners by now where INRs are not monitored! My mother had all the conditions your mom has, plus advanced dementia, and lived to 95. But she didn't break her hip and leg bone at 90. Can your mom be kept comfortable without surgery, is that even possible? Have you had that conversation? I'm sure she'd be bedbound, but she may be bedbound or at least wheelchair bound after the THR anyway. There's no way to know. I'd keep her in rehab for the entire recovery period if this were me, and pay out of pocket, if you move forward with the surgery.
Best of luck to you.
My neighbor, age 77, broke her left shoulder and right hand tripping over a parking lot bumper. She is going to PT but is fearful of walking now.
As a co-POA I went ahead even before this and had gotten palliative care on board hoping for hospice eventually but have met resistance. He has refused to even discuss how to handle her care in the future at all but have taken control of things. I’ve just this week pulled back for my own health and well being and left her healthcare totally up to them, other than staying with her at our previously agreed times. it’s like pushing against a brick wall. Really stressful and have been having attacks of anxiety with chest pain.
I’m hoping someone at the hospital will speak up. they’re saying it will be at best 6-8 weeks of non weight bearing. How in the world will we handle it? Absolutely hate that they are going to put her through this.
You already know and have been told by MD the complicating factors, as you have told us here. There is in an distinct danger of stroke in one with atrial fib. Clots in healing where extremities are concerned are complicating and the fact that this is already a total hip with a fx. may be further complicating.
This is something you clearly cannot predict, but living with a fractured hip truly isn't an option. Speak with the doctors who know this case best, hope for the best. I wish you well and hope you'll update us.
I may be wrong....
There is a good possibility that your mom will not be mobile after the repair. It would depend on how well she does in rehab. But the fear of falling again my hinder her.
Given her medical conditions there is a good possibility that with or without the surgical repair mom my have 6 to 9 months.
Once the repair is done you might want to get an evaluation for Hospice. They will provide you with all the equipment that you will need as well as all the medications that she needs and personal supplies. Nurse will visit once a week, more often if needed. A CNA will come 2 times a week to give mom a bath or shower. Bed Bath if needed. And you can ask for a Volunteer that can come sit with mom while you can get things done or the Volunteer can do other tasks. About the only thing a Volunteer can not do is "hands on care".
If mom is currently in a facility she may have to move to a Skilled Nursing facility as most other facilities can not sue equipment to move a resident.
This is a tough decision if you are asked to decide on surgery or not.